Promoting fair and equitable research partnerships to respond to global challenges

This report presents the findings from a programme of strategic research funded by UKRI through the GCRF. The research sought to elicit a 'partners' perspective' on participation in UKRI-funded research by generating data from three groups of partner: i) academics based in the global South; ii) civi society practitioners based in the global South; and iii) international NGOs and research capacity providers based in the UK. Drawing on this data, the report identifies eight principles for understanding and improving fair and equitable research collaboration which form the basis of a series of targeted learning modules for 6 groups of stakeholders: UK-based research funders; UK-based academics; research brokers and capacity providers; international NGOs; academics based in the global South; and civil society practitioners based in the global South

Treatment of Pseudo Class III Malocclusion with Multiple Loop Protraction Utility Arch

Pseudo Class III malocclusion has been characterized by an anterior crossbite in the presence of a forward mandibular displacement. There are various methods to correct pseudo Class III malocclusion, e.g., Inclined planes, reverse stainless steel crown, bonded composite resin slopes, tongue blade, the removable appliance with auxiliary springs, and maxillary lingual arch with finger springs. In this article, we are presenting a case of pseudo Class III malocclusion treated with multiple loop protraction utility arch. Patient had functional mandibular anterior deviation resulting into traumatic anterior cross bite and concave profile. We fabricated multiple loop arch wire (0.016”×0.022” blue elgiloy) which was activated at four 90° bends without disturbing other segments of the arch

Jaw Morphology and Vertical Facial Types: A Cephalometric Appraisal

Aims and objectives: To evaluate the maxillary and mandibular morphology in different vertical facial types and to implicate the achieved results into diagnosis and treatment planning of patients requiring orthodontic treatment. Materials and methods: The present study is conducted on a sample of 120 subjects comprising of 60 males and 60 females in the age range of 18 to 25 years. The lateral head cephalograms of the subjects were divided into three groups, i.e. group I (hypodivergent), group II (normodivergent) and group III(hyperdivergent) with regard to vertical facial type by using the following three parameters, i.e. SN-MP (facial divergence angle), overbite depth indicator (ODI) and Jarabak ratio or facial height ratio (FHR). Differences among the groups and between genders were assessed by means of variance analysis and Newman- Keuls post hoc test. Results: Maxillary and mandibular anterior alveolar and maxillary postalveolar height was found to be greater for hyperdivergent group in comparison to others. Hyperdivergent facial types posseslong and narrow symphysis along with greater antegonial notch depth whereas hypodivergent showed an opposite tendency. Hyperdivergent facial types generally have a smaller maxillary area as compared to other facial types. However, total mandibular area does not vary among different vertical facial types. Sexual dichotomy was found with maxillary anterior alveolar and basal height, mandibular posterior alveolar and basal height, mandibular length, symphyseal depth, depth of the antegonial notch, symphyseal area and ext/total symphyseal area ratio. Conclusion: Vertical facial type may be related to the morphological and dentoalveolar pattern of both maxilla and mandible. Determination of this relationship may be of great help from diagnostic as well as therapeutic aspects of many vertical malocclusion problems

Expression of isocitrate dehydrogenase 1 and tumor protein 53 in high-grade glioma and its correlation with the outcome – A prospective study at a tertiary care center in India

Background: Central nervous system tumors are the 10th most prevalent cause of mortality worldwide. The 2016 World Health Organization (WHO) classification of high grade gliomas (HGG) has identified Isocitrate dehydrogenase 1 (IDH 1) mutation as one of the primary molecular markers. Tumor protein 53 (p53) mutation is also closely associated with HGG. Aims and Objectives: The current study intended to ascertain the expression of IDH1 and P53 in patients with HGG and correlate that expression with clinical prognosis. Materials and Methods: The study included 34 patients with histopathological proven HGG. Relevant clinical information was recorded. The immunostaining results with anti-mouse monoclonal antibody for IDH 1 (R132H) and rabbit polyclonal antibody for p53 (RP 106-05) were statistically analyzed. Patients were followed up through telephone for a period of 1 year. Mortality within 1 year was regarded as a poor outcome. Results: About 85.29% (29/34) of the patients had Grade IV glioma, while only 14.71% (5/34) had Grade III glioma. Most patients with Grade III (3/5) (60.00%) and Grade IV (21/29) (72.41%) gliomas had p53 positivity. The majority of the patients with grade-III glioma (3/5) (60.00%) had IDH1 positivity, while most of the patients (23/29) (79.31%) with Grade IV gliomas had IDH1 negativity (P=0.0658). Age, gender, WHO grade, and adjuvant therapy did not show significant association with the outcome except for the p53 expression (P=0.0011*) and IDH1 expression (P=0.0025*). Correlation analysis showed a significant positive correlation between p53 makers with poor outcome (r=0.4781) and glioma grade (r=0.4028). Further, a negative yet insignificant correlation was recorded between IDH1 with age (r=−0.2285), p53 expression (r=−0.2568), and grade (r=−0.2988), although it showed a significant correlation with poor outcome (P=0.0001). Conclusion: p53-positive and IDH1-negative HGG had a significant correlation with the poor outcome. Thus, IDH1 and p53 are reliable markers for prognostication of HGG

Assessment of Serum Vascular Endothelial Growth Factor Levels in Pregnancy-Induced Hypertension Patients

Objective. The objective of the study was to assess the serum vascular endothelial growth factor (VEGF) levels in peripheral blood of patients with pregnancy-induced hypertension (PIH) and find association between serum VEGF levels and PIH. Methods. Thirtyfive PIH subjects, 35 normal pregnant females, and 20 normal healthy females were included in the study. Detailed history, clinical examination, and relevant biochemical parameters were assessed; serum VEGF levels were estimated using Double-antibody enzyme-linked immunosorbent assay. Results. The study groups were found to be age matched ( = 0.38). VEGF level in the pregnancy-induced hypertensive group (median = 109.19 (3.38 ± 619)) was significantly higher than the normal pregnant (median = 20.82 (1.7-619)) and control (median = 4.92 (1.13-13.07)) group and the difference between these three groups was significant ( < 0.0001). The 3 groups are found to be significantly different in terms of RBS ( = 0.01), urea ( < 0.0001), creatinine ( = 0.0005), AST ( = 0.0032), ALT ( = 0.0007), total protein ( = 0.0004), albumin ( < 0.0001), calcium ( = 0.001), and sodium ( = 0.02), while no statistically significant difference was found between total bilirubin ( = 0.167), direct bilirubin ( = 0.07), uric acid ( = 0.16), and potassium ( = 0.14). Conclusion. Significantly higher levels of serum VEGF were noted in PIH subjects compared to normal pregnant and control subjects

Development and design of the first structured clinic-based program in lower resource settings to transition emerging adults with type 1 diabetes from pediatric to adult care

Introduction Type 1 diabetes (T1D) is increasing in young people worldwide and more children in resource limited settings are living into adulthood. There is a need for rigorous testing and reporting of evidence-based and stakeholder-informed strategies that transition individuals with T1D from pediatric to adult care. We present the development of and design of the first structured transition program in Delhi, India, to inform similar efforts in India and resource limited settings. Methods The intervention development team included clinicians and researchers with expertise in T1D and the implementation context. To select intervention outcomes, establish intervention targets, and design session modules, we drew upon formative research conducted at prospective intervention implementation sites, consensus guidelines, and previous care transition and behavior change research conducted in developed settings. We used the Template for Intervention Description and Replication and GUIDance for the rEporting of intervention Development checklists to report the intervention and development process. Results The 15-month program (“PATHWAY”) includes five quarterly ~30 minute sessions delivered predominantly by diabetes educators at pediatric and adult clinics, which coincide with routine care visits. Primary program components include educational and behavioral sessions that address psychosocial drivers of clinic attendance and self-management, diabetes educators as transition coordinators and counselors, and a one-year “overlap period” of alternating visits between pediatric and adult providers. Conclusions We followed a systematic and transparent process to develop PATHWAY, which facilitated rich description of intervention context, guiding principles, targets, and components. Dependence on previously published program examples to design PATHWAY may have introduced challenges for program feasibility and effectiveness, underscoring the importance of input gathering from prospective intervention actors at multiple points in the development process. This detailed report in combination with future evaluations of PATHWAY support efforts to increase rigorous development and testing of strategies to improve outcomes among emerging adults with T1D

Evaluation of Stress Pattern Caused by Mini-Implant in Mandibular Alveolar Bone with Different Angulations and Retraction Forces: A Three-Dimensional Finite Element Study

Objective:The objective of the study was to evaluate the stress pattern in cortical and cancellous bones, periodontal ligament, and in the implant itself when a mini-implant (MI) is inserted in the inter-radicular space between mandibular first molar and second premolar at various angulations and different retraction forces.Methods:Finite element study was conducted with MI insertion at 30°, 45°, 60°, 75°, and 90° angulations in the mandibular posterior region (between second premolar and first molar). At these angulations, horizontal forces of 150, 200, and 250 g were applied to the middle of the MI head. von Mises stress values were then evaluated using the ANSYS software.Results:Highest von Mises stress values were detected in the MI itself, followed by cortical bone, cancellous bone, and periodontal ligament. The von Mises stress values in cortical bone were highest at 30° angulation and lowest at 90° angulation. In the cancellous bone, the stress value was found to be maximum at 90°. The von Mises stress values in the MI were lowest at 90°. In all four structures, as the load increased from 150 to 250 g, the von Mises stress values increased.Conclusion:The von Mises stress values in the cortical bone, MI, and periodontal ligament were found to be lowest at 90°. Placement of the MI at 90° appears to be an ideal angulation when applied with a horizontal load. Force range used is within clinically recommended levels; however, the increase in load causes an increase in the stress values

Molecular profiling of ETS and non‐ETS aberrations in prostate cancer patients from northern India

BACKGROUNDMolecular stratification of prostate cancer (PCa) based on genetic aberrations including ETS or RAF gene‐rearrangements, PTEN deletion, and SPINK1 over‐expression show clear prognostic and diagnostic utility. Gene rearrangements involving ETS transcription factors are frequent pathogenetic somatic events observed in PCa. Incidence of ETS rearrangements in Caucasian PCa patients has been reported, however, occurrence in Indian population is largely unknown. The aim of this study was to determine the prevalence of the ETS and RAF kinase gene rearrangements, SPINK1 over‐expression, and PTEN deletion in this cohort.METHODSIn this multi‐center study, formalin‐fixed paraffin embedded (FFPE) PCa specimens (n = 121) were procured from four major medical institutions in India. The tissues were sectioned and molecular profiling was done using immunohistochemistry (IHC), RNA in situ hybridization (RNA‐ISH) and/or fluorescence in situ hybridization (FISH).RESULTSERG over‐expression was detected in 48.9% (46/94) PCa specimens by IHC, which was confirmed in a subset of cases by FISH. Among other ETS family members, while ETV1 transcript was detected in one case by RNA‐ISH, no alteration in ETV4 was observed. SPINK1 over‐expression was observed in 12.5% (12/96) and PTEN deletion in 21.52% (17/79) of the total PCa cases. Interestingly, PTEN deletion was found in 30% of the ERG‐positive cases (P = 0.017) but in only one case with SPINK1 over‐expression (P = 0.67). BRAF and RAF1 gene rearrangements were detected in ∼1% and ∼4.5% of the PCa cases, respectively.CONCLUSIONSThis is the first report on comprehensive molecular profiling of the major spectrum of the causal aberrations in Indian men with PCa. Our findings suggest that ETS gene rearrangement and SPINK1 over‐expression patterns in North Indian population largely resembled those observed in Caucasian population but differed from Japanese and Chinese PCa patients. The molecular profiling data presented in this study could help in clinical decision‐making for the pursuit of surgery, diagnosis, and in selection of therapeutic intervention. Prostate 75:1051–1062, 2015. © 2015 The Authors. The Prostate, published by Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/111808/1/pros22989.pd

Effectiveness and cost-effectiveness of a Yoga-based Cardiac Rehabilitation (Yoga-CaRe) program following acute myocardial infarction: study rationale and design of a multi-centre randomized controlled trial

© 2019 Background: Cardiac rehabilitation (CR) is a standard treatment for secondary prevention of acute myocardial infarction (AMI) in high income countries (HICs), but it is inaccessible to most patients in India due to high costs and skills required for multidisciplinary CR teams. We developed a low-cost and scalable CR program based on culturally-acceptable practice of yoga (Yoga-CaRe). In this paper, we report the rationale and design for evaluation of its effectiveness and cost-effectiveness. Methods: This is a multi-center, single-blind, two-arm parallel-group randomized controlled trial across 22 cardiac care hospitals in India. Four thousand patients aged 18–80 years with AMI will be recruited and randomized 1:1 to receive Yoga-CaRe program (13 sessions supervised by an instructor and encouragement to self-practice daily) or enhanced standard care (3 sessions of health education) delivered over a period of three months. Participants will be followed 3-monthly till the end of the trial. The co-primary outcomes are a) time to occurrence of first cardiovascular event (composite of all-cause mortality, non-fatal myocardial infarction, non-fatal stroke and emergency cardiovascular hospitalization), and b) quality of life (Euro-QoL-5L) at 12 weeks. Secondary outcomes include need for revascularization procedures, return to pre-infarct activities, tobacco cessation, medication adherence, and cost-effectiveness of the intervention. Conclusion: This trial will alone contribute >20% participants to existing meta-analyses of randomized trials of CR worldwide. If Yoga-CaRe is found to be effective, it has the potential to save millions of lives and transform care of AMI patients in India and other low and middle income country settings